molluscum contagiosum
Introduction
Introduction to infectious soft palate Infectious soft palate (molluscumcontagiosum) is a self-inoculation viral skin disease caused by infectious soft prion. It is characterized by multiple hemispherical, waxy glaucoma, central umbilical fossa, and extrudable cheese. Soft corpus callosum. Occurs in children and young people, commonly known as "water scorpion." Infected by infectious soft prion, a contagious soft prion belongs to a DNA virus in the family of poxviruses. It is mainly infected by direct contact. Patients are often infected in public baths or swimming pools. They can also be vaccinated by themselves or through Sexual contact infection. basic knowledge The proportion of illness: 0.0013% Susceptible people: no special people Mode of infection: contagious Complications: Eczema
Cause
Infectious soft palate
Virus factor (30%):
The disease is caused by infectious soft prion (CMV), which is a acne virus. It is brick-shaped and has a diameter of 350 nm. It is sometimes seen under light microscopy. According to electron microscopy, the formation and cytoplasm of the virus itself. Closely related, the cytoplasmic matrix is first concentrated, and eosinophilic particles appear, and these particles gradually agglomerate to form a "large particle" with a clear boundary with the surrounding - a particle combination virus (initial type virus); and then develop into a fine particle film Type virus (medium virus); finally becomes brick-shaped, elliptical or round, often with a dumbbell-like structure of mature virus in its center, and the entire cytoplasmic matrix eventually becomes a virus inclusion body (also known as soft corpus callosum) This corpuscle was originally an oval-shaped eosinophilic structure, which was positive for Brachet reaction, indicating more RNA. Soon Feulgen staining showed that DNA began to show a positive reaction. As the volume expanded rapidly, Feulgen reaction gradually strengthened, while Brachet The reaction is gradually weakened, which indicates that the amount of RNA is higher in the early stage, and the DNA is more in the late stage. The Chinese medicine believes that the blood is lost, the phlegm is not dense, the complex is exogenous, the skin is caused by agglutination, and the contagious soft palate Benign virus Skin diseases, skin rash wax-like luster diameter of 2 ~ 4mm bead papules, top recess can be shaped extruded cheese molluscum bodies.
Prevention
Infectious soft palate prevention
Pay attention to hygiene, cut your nails, avoid scratching your skin, and not share your clothes with your patients. It has a certain effect on preventing this disease.
Complication
Infectious soft palate complications Complications eczema
Often due to conscious itch, sputum after infection or secondary eczema-like damage.
Symptom
Contagious soft palate symptoms Common symptoms Pimples qi and blood loss and itching round or oval dome...
The incubation period is from 1 week to 6 months. The typical damage is the papules formed by the infection of infected local epidermal cells. The diameter is 2-8 mm, single or multiple, round or hemispherical, waxy luster, central umbilicus, and contains cheese-like embolism. The pimples are flesh-colored or pink, the initial texture is hard, mature and soft, and the cheese can be squeezed out. The clinical can be divided into two types:
1 Child type: It is directly contacted by the skin or infected by the vector. The soft palate is found on the face, trunk and limbs.
2 adult type: can be sexually transmitted, soft palate is more common in the external genitalia, buttocks, lower abdomen, pubic bone and inner thigh area, anal sex occurs in the anus, Lynch reported 55 cases of such cases, from Vietnam and North Korea back to the United States Soldiers, they have a history in the country.
Skin lesions can occur in any contact area other than palmar, but also in the lips, tongue and buccal mucosa, conjunctiva, etc. Conjunctival damage can be accompanied by reactive conjunctivitis or keratitis, a few damage is extremely large, called giant soft wart. Some can be keratinized like a small leather corner, called keratotic soft palate. Generally no symptoms.
In cases of HIV infection, the incidence of infectious soft palate increased, and soft palate spread widely and suffered large damage. It has been reported that AIDS patients have huge soft palate on the face and are easily confused with basal cell epithelial tumors. In addition, two extensive, acute, hundreds of soft palate patients have been reported to receive immunosuppressive agents. A history of prednisolone and methotrexate treatment suggests that the onset is related to its immunosuppression.
The disease is self-limiting and generally lasts for several months to several years.
Examine
Infectious soft palate inspection
Infectious viral granules and antigen detection method for infectious soft prion:
1. Directly check the virus particles:
Method 1: Smear staining: Extrusion of cheese samples, Reiter staining. Result: soft palate body (+).
Method 2: Electron microscopy: biopsy specimens. Result: Soft prion (+).
Method 3: Check histopathology. Results: Diagnostic characteristics.
2. Direct detection of viral antigens:
Method 1: Agar gel precipitation test (AGP). Result: (+).
Method 2: Complement binding assay (CF). Result: (+).
Method 3: Indirect immunofluorescence assay (IIF). Result: (+).
Method 4: Neutralization test (Nt). Result: (+).
Histopathology: The lesion is mainly in the epidermis, the epidermis is highly proliferating and extends into the dermis, and the connective tissue around the dermis is compressed to form a pseudo-envelope, which is divided into a plurality of piriform lobes, and the dermal papilla is compressed, which becomes an abnormality between the lobes. In the narrow interval, the basal cells are generally normal, and gradually degenerate from the acanthosis cells. In the early stage, the infected cells begin to form oval bodies, and then the cell volume gradually increases, the nucleus condenses, and finally the whole cytoplasm is hobby. Oxygen inclusion bodies (soft corpus callosum) occupy, in the middle of the epidermis, the soft corpus callosum has exceeded the original volume of the affected cells, the nucleus is squeezed on one side, condensed into a crescent shape, or even completely disappeared, in the granule At the level, the soft palate body changes from eosinophilic to basophilic. There are many basophilic soft palate bodies in the stratum corneum. Because not all the spine cells have the above degeneration, a few keratinizations are still visible in the middle of the cells. In the center of the lesion, the denatured cells can fall off to form a central cavity and communicate with each of the pear-shaped leaflets without any change in the dermis.
Diagnosis
Infectious soft palate diagnosis
diagnosis
According to the disease, there is a round or hemispherical papule with a waxy luster in the clinic. The central umbilicus is concave, and the extrudable cheese-like substance and histopathology have characteristics. It is easy to diagnose. If the genital area is damaged, the young person should be checked. For local sexually transmitted diseases, large lesions should be differentiated from basal cell carcinoma and keratoacanthoma.
The incubation period is 2 to 3 weeks. It starts from a hemispherical papule of cap needle to mung bean. The surface is waxy and lustrous. The central umbilical fossa is normal skin color. It gradually enlarges to the peas. It can be discharged into white cheese-like soft palate. Small body, children are more common in the face, limbs and limbs (Figure 1), adults can occur throughout the body, seen by sexual communicators in the vulva, buttocks, lower abdomen and thighs, can also appear in the lips, cheek mucosa, conjunctiva, etc. The number is different, scattered, non-integrated, consciously itching, chronic disease course, self-limiting, lasting for several months, self-return, more common in children and young people, incubation period is 14 days to 6 months, from the beginning The rice has a large hemispherical papule, which gradually increases to the peas. The center is slightly concave or umbilical. The surface has a waxy luster. The early texture is tough, and then gradually softens. It is grayish white or pearly. It can be squeezed out of white cheese-like substance. For the soft corpus callosum, the number of damage varies from several to tens of, appearing one after another, or a few scattered, or several clusters, do not merge with each other, all parts of the body surface can occur, occur in the trunk, limbs Shoulder, yin The sac and anus can also occur in the lips, tongue, buccal mucosa and conjunctiva. The rash area varies according to the way of contact. Generally, there are no symptoms. In rare cases, the damage is abnormally called giant soft sputum, and some horns. It is like a small leather horn, called keratotic soft palate. The skin lesions can disappear naturally by accident, and no scars are left behind.
The clinical and histological aspects of the disease are very special, and the general diagnosis is not difficult.
Traditional Chinese medicine pathogenesis: commonly known as water scorpion, Chinese medicine "rat milk" is similar to this disease, "The source of various diseases" mouse milk records "the mouse milk, body and suddenly raw meat, such as the shape of rat milk, said the rat "Milk is also", Chinese medicine believes that this system is qi and blood loss, is not close to the senses, relapses the external evils, and condenses the skin.
Differential diagnosis
According to the disease, there is a round or hemispherical papule with a waxy luster in the clinic. The central umbilicus is concave, and the extrudable cheese-like substance and histopathology have characteristics. It is easy to diagnose. If the genital area is damaged, the young person should be checked. For local sexually transmitted diseases, large lesions should be differentiated from basal cell carcinoma and keratoacanthoma.
1. Sweat tube tumor: It occurs around the eyelids of women. It is a small nodule with needle size to rice size. It is dense, normal skin tone or light brown, hard and hard. There is no soft palate body in the center and it is not contagious.
2. Papular urticaria: a common allergic skin disease in children, initially a spindle-shaped edematous red maculopapular rash, gradually becoming a hard blisters, with apical protrusions, no depressions, no small body discharge, and itching.
